4 Failed IVFs

CaribbeanQueen83

3 Posts
Reply Posted on: Dec 2, 2013 at 8:17am
Hi Dr Braverman,

I am seeking your insight on the captioned matter and possible next steps. I've done 4 IVFs in a 1 year time period of which 3 resulted in negative betas and 1 was cancelled (all embryos arrested before day 5).

For my first IVF I was on Follistim 225, Menopur 2 vials, Ganirelix 250 for the first protocol. Got 12 eggs, 8 mature, 7 fert and did a 4dt with 2. The 2 that were transferred were Morulas. Negative. None to freeze.

Second time we used Follistim 375 (which was lowered), Menopur 2 vials was on Lupron 10 then down to 5. Got 13 eggs, 6 mature (3 were overnight maturers), 6 fert and did a 4dt with 2. Negative. Of the 2 that were transferred, 1 was an early blast and the other a morula. None to freeze.

Before my 3rd IVF I was diagnosed with borderline activated NK cells (15.1). This was treated with 20% intralipids prior to IVF. No other immune testing was done at that time. For IVF 3 we did Follistim 350, half vial of Menopur and Lupron - ended up with 7 eggs and only 1 mature...2 matured overnight none made it to blast so ET was cancelled.

My 4th cycle was in October which consisted of 575 Follistim (lowered to 375 after 2 days), half vial of Menopur and Ganirelix 125. We got 10 eggs, 8 mature and 8 fertilized. However only 1 made it to early blast on day 5 and was graded 1. Negative. None made it to freeze.

We have since looked into further immune testing and had the thrombolia panel or bloodclotting panel done. We also tested my Cytokines. Thrombolia all came back normal. I was found to be grossly deficient in Vitamin D (heard this affects egg quality), I am at a 11 and normal values are between 30-100. I also found out my th-1 was relatively high at 34 with normal being below 32 and abnormally high being above 36. What else would you recommend testing? Or do you think this is enough and could be the reason for possible implantation failure. I should also be doing an endo biopsy - do you think this is beneficial?
Thanks in advance!

Dr. Braverman

2026 Posts
RE: 4 Failed IVFs Posted on: Dec 2, 2013 at 3:30pm
This is not at all enough to make any diagnosis. You need a very detailed immune workup which I can assist you with . Feel free to fill out a consult request on my website and I will be happy to arrange a free 10 minute chat with you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

CaribbeanQueen83

3 Posts
Reply RE: 4 Failed IVFs Posted on: Dec 3, 2013 at 6:32am
Thanks for responding Dr Braverman. What tests could I be missing from an immune perspective? We did the NK assay, Cytokines, Blood clotting which included ANA etc. Just wondering...cause I thought we caught everything.

Dr. Braverman

2026 Posts
RE: 4 Failed IVFs Posted on: Dec 3, 2013 at 6:36am
The immune panels that are run are very deficient , there are about 50 other pieces of data that are missing. Most that run these tests do not truley have a grasp on the function of the entire immune system which is necessary to make a correct diagnosis and recommend the best treatment.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.